Resting energy expenditure before and after surgical resection of gut lesions in pediatric Crohn's disease

被引:39
作者
Varille, V
Cezard, JP
deLagausie, P
Bellaiche, M
Tounian, P
Besnard, M
Faure, C
Aigrain, Y
Girardet, JP
Navarro, J
机构
[1] HOP ROBERT DEBRE,CLIN INVEST CTR,F-75019 PARIS,FRANCE
[2] HOP ROBERT DEBRE,DEPT PEDIAT SURG,F-75019 PARIS,FRANCE
[3] HOP TROUSSEAU,DEPT PEDIAT GASTROENTEROL & NUTR,F-75571 PARIS,FRANCE
关键词
resting energy expenditure; fat-free body mass; gut resection; Crohn's disease;
D O I
10.1097/00005176-199607000-00003
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
In pediatric Crohn's disease (CD), resection of gut lesions is necessary to remove stenoses and when frequent relapses occur despite nutritional support and medical treatment. After surgery, improved nutritional status and accelerated growth usually follow increased nutritional intake and lower doses of steroids. The aim of this study was to compare energy balance before and after surgery while nutritional intake and steroid therapy were unchanged. Eleven patients, aged 14.5 +/- 2.5 years and with mildly active CD, were explored 1 week before and 1 month after gut resection for stenosis (n = 7) and medical treatment failure (n = 4). Eleven matched children participated in the study as controls. Disease activity was assessed by the Pediatric Crohn's Disease Activity Index and serum orosomucoid concentration. Resting energy expenditure (REE) was measured by indirect calorimetry, and fat-free body mass (FFM) was measured by anthropometry. The patients' mean REE decreased from 46.6 +/- 10.5 kcal/kg FFM/day before surgery to 42.6 +/- 10.3 kcal/kg FFM/day after surgery, while the controls' mean REE was 39 +/- 7 kcal/kg FFM/day (analysis of variance, p = 0.02). After surgery, body weights were not significantly different, but the mean protein oxidation rate was reduced and arm muscle area was increased. Changes in REE per kilogram of FFM per day were not correlated with changes in orosomucoid serum concentrations (r(2) = 0.35; p = 0.4). In conclusion, in children with mildly active CD, while nutritional intake and steroid therapy were maintained at preoperative levels, a significant decrease in REE acid improved nitrogen utilisation were observed 1 month after resection of the CD gut lesion. This finding suggests better use of energy substrates when CD lesions are removed.
引用
收藏
页码:13 / 19
页数:7
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